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coronary microvascular dysfunction

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https://www.readbyqxmd.com/read/29353224/coronary-microvascular-dysfunction-may-be-related-to-igf-1-in-acromegalic-patients-and-can-be-restored-by-therapy
#1
Sara Tellatin, Pietro Maffei, Elena Osto, Francesca Dassie, Giulia Famoso, Roberta Montisci, Chiara Martini, Francesco Fallo, Martina Perazzolo Marra, Roberto Mioni, Sabino Iliceto, Roberto Vettor, Francesco Tona
BACKGROUND AND AIMS: Acromegaly increases the risk of cardiovascular mortality. Data on the cardiovascular risk in asymptomatic acromegaly are limited. In particular, data on coronary microvascular abnormalities are lacking. We assessed coronary flow reserve (CFR) as a marker of coronary microvascular function in asymptomatic acromegaly. METHODS: We studied 40 acromegalic patients (23 male, age 52 ± 11 years) without clinical evidence of cardiovascular disease, and 40 control subjects matched for age and sex...
December 24, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29348027/implications-of-underlying-mechanisms-for%C3%A2-the-recognition-and-management-of-diabetic-cardiomyopathy
#2
REVIEW
Thomas H Marwick, Rebecca Ritchie, Jonathan E Shaw, David Kaye
Heart failure is a complex clinical syndrome, the incidence and prevalence of which is increased in diabetes mellitus, pre-diabetes, and obesity. Although this may arise from underlying coronary artery disease, it often occurs in the absence of significant major epicardial coronary disease, and most commonly manifests as heart failure with preserved ejection fraction. Despite epidemiological evidence linking diabetes to heart failure incidence and outcome, the presence of a distinct primary "diabetic" cardiomyopathy has been difficult to prove, because the link between diabetes and heart failure is confounded by hypertension, microvascular dysfunction, and autonomic neuropathy...
January 23, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29346550/coronary-microvascular-dysfunction-and-heart-failure-with-preserved-ejection-fraction-as-female-pattern-cardiovascular-disease-the-chicken-or-the-egg
#3
Michael D Nelson, Janet Wei, C Noel Bairey Merz
No abstract text is available yet for this article.
January 16, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29344840/design-and-rationale-for-comparison-between-ticagrelor-and-clopidogrel-on-microcirculation-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-pleio-trial
#4
Kyungil Park, Young-Rak Cho, Jong-Sung Park, Tae-Ho Park, Moo-Hyun Kim, Young-Dae Kim
It has been previously demonstrated that ticagrelor can reduce mortality compared to clopidogrel in acute coronary syndrome (ACS) patients. However, the mechanism for this mortality reduction remains uncertain. The objective of the present study is to assess the impact of chronic ticagrelor treatment on microvascular circulation. A total of 120 participants aged 20-85 years with clinical diagnosis of ACS will be randomized in a 1:1 fashion to the following two groups: ticagrelor 90 mg twice daily; clopidogrel 75 mg once daily...
January 17, 2018: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/29325551/relationship-between-cardiac-microvascular-dysfunction-measured-with-82rubidium-pet-and-albuminuria-in-patients-with-diabetes-mellitus
#5
Louis Potier, Renata Chequer, Ronan Roussel, Kamel Mohammedi, Souad Sismail, Agnès Hartemann, Chloé Amouyal, Michel Marre, Dominique Le Guludec, Fabien Hyafil
BACKGROUND: Albuminuria is of one the strongest predictors of cardiovascular disease (CVD) in diabetes. Diabetes is associated with cardiac microvascular dysfunction (CMD), a powerful, independent prognostic factor for cardiac mortality. The aim of this study was to evaluate the relationship between CMD and microvascular complications in patients without known CVD. METHODS: In this monocentric study, myocardial flow reserve (MFR) was measured with cardiac 82Rubidium positron emission tomography (Rb-PET) in 311 patients referred to nuclear medicine department of Bichat University Hospital for screening of coronary artery disease from 2012 to 2014...
January 11, 2018: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29321034/diagnostic-and-prognostic-utility-of-cardiovascular-magnetic-resonance-imaging-in-heart-failure-with-preserved-ejection-fraction-implications-for-clinical-trials
#6
Prathap Kanagala, Adrian S H Cheng, Anvesha Singh, John McAdam, Anna-Marie Marsh, Jayanth R Arnold, Iain B Squire, Leong L Ng, Gerry P McCann
BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a poorly characterized condition. We aimed to phenotype patients with HFpEF using multiparametric stress cardiovascular magnetic resonance imaging (CMR) and to assess the relationship to clinical outcomes. METHODS: One hundred and fifty four patients (51% male, mean age 72 ± 10 years) with a diagnosis of HFpEF underwent transthoracic echocardiography and CMR during a single study visit. The CMR protocol comprised cine, stress/rest perfusion and late gadolinium enhancement imaging on a 3T scanner...
January 11, 2018: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/29315085/biopsy-confirmed-endothelial-cell-activation-in-patients-with-coronary-microvascular-dysfunction
#7
Hannes Lindemann, Ivana Petrovic, Stephan Hill, Anastasios Athanasiadis, Heiko Mahrholdt, Tim Schäufele, Karin Klingel, Udo Sechtem, Peter Ong
BACKGROUND: Patients with angina yet having unobstructed coronaries are found in ∼50% of cases undergoing invasive angiography. Coronary spasm and microvascular dysfunction can be responsible for the clinical presentation in ∼60% of cases. However, little is known about structural changes in the myocardium. The aim of this study was to describe findings in endomyocardial biopsies of symptomatic patients with unobstructed coronaries. PATIENTS AND METHODS: We retrospectively analyzed a cohort of 1416 consecutive patients who underwent endomyocardial biopsy sampling and coronary angiography between 2002 and 2016 for various clinical indications...
January 8, 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29314204/telmisartan-ameliorates-vascular-endothelial-dysfunction-in-coronary-slow-flow-phenomenon-csfp
#8
Zhe Jin, Qindong Tan, Bei Sun
Coronary slow flow phenomenon (CSFP) is a coronary microvascular disorder with an increasing morbidity, and currently, available therapies are of limited clinical value for its cure. Hence, it is urgent to find a novel approach to CSFP treatment. Several studies show that endothelial dysfunction plays a critical role in the aetiology of CSFP. Telmisartan (TMST) is a clinically available anti-hypertensive medicine and has shown its potential properties for improving vascular endothelial function. Thus, we aimed to investigate the effect of TMST on endothelial dysfunction in CSFP, Endothelial-dependent flow-mediated vasodilation, serum levels of nitric oxide, adiponectin, and endothelin-1 were surveyed before and after 3 months of TMST treatment...
January 2018: Cell Biochemistry and Function
https://www.readbyqxmd.com/read/29273789/widespread-coronary-dysfunction-in-the-absence-of-hdl-receptor-sr-b1-in-an-ischemic-cardiomyopathy-mouse-model
#9
James T Pearson, Misa Yoshimoto, Yi Ching Chen, Rohullah Sultani, Amanda J Edgley, Hajime Nakaoka, Makoto Nishida, Keiji Umetani, Mark T Waddingham, Hui-Ling Jin, Yuan Zhang, Darren J Kelly, Daryl O Schwenke, Tadakatsu Inagaki, Hirotsugu Tsuchimochi, Issei Komuro, Shizuya Yamashita, Mikiyasu Shirai
Reduced clearance of lipoproteins by HDL scavenger receptor class B1 (SR-B1) plays an important role in occlusive coronary artery disease. However, it is not clear how much microvascular dysfunction contributes to ischemic cardiomyopathy. Our aim was to determine the distribution of vascular dysfunction in vivo in the coronary circulation of male mice after brief exposure to Paigen high fat diet, and whether this vasomotor dysfunction involved nitric oxide (NO) and or endothelium derived hyperpolarization factors (EDHF)...
December 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29242099/downregulation-of-circulating-mots-c-levels-in-patients-with-coronary-endothelial-dysfunction
#10
Qing Qin, Silvia Delrio, Junxiang Wan, R Jay Widmer, Pinchas Cohen, Lilach O Lerman, Amir Lerman
BACKGROUND: MOTS-c is one of the newly identified mitochondrial-derived peptides which play a role in regulating metabolic homeostasis. The current study aimed to investigate whether circulating MOTS-c levels are also associated with endothelial dysfunction(ED) in patients without significant structural coronary lesions. METHODS: Forty patients undergoing coronary angiography and endothelial function testing for clinical indications of recurrent angina with no structural coronary lesions were included in the study...
December 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29230571/correlation-of-left-ventricular-dyssynchrony-on-gated-myocardial-perfusion-spect-analysis-with-extent-of-late-gadolinium-enhancement-on-cardiac-magnetic-resonance-imaging-in-hypertrophic-cardiomyopathy
#11
Hideaki Yuki, Daisuke Utsunomiya, Shinya Shiraishi, Seiji Takashio, Fumi Sakamoto, Noriko Tsuda, Seitaro Oda, Masafumi Kidoh, Takeshi Nakaura, Kenichi Tsujita, Yasuyuki Yamashita
Myocardial perfusion-single-photon emission computed tomography (MP-SPECT) is used to evaluate microvascular dysfunction and coexisting coronary artery disease in patients with hypertrophic cardiomyopathy (HCM). Phase analysis in gated MP-SPECT can provide additional information on left ventricular (LV) dyssynchrony, while the extent of late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) imaging is an important prognostic factor in patients with HCM. We, therefore, sought to investigate the relationship of dyssynchrony by phase analysis on gated MP-SPECT and LGE on CMR imaging in 22 patients with HCM who underwent both stress/rest-gated MP-SPECT and contrast-enhanced CMR imaging...
December 11, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29222822/coronary-microvascular-dysfunction-and-myocardial-contractile-reserve-in-women-with-angina-and-no-obstructive-coronary-artery-disease
#12
Marie M Michelsen, Adam Pena, Naja D Mygind, Jan Bech, Ida Gustafsson, Jens Kastrup, Henrik S Hansen, Nis Høst, Peter R Hansen, Eva Prescott
BACKGROUND: Coronary microvascular dysfunction (CMD) is a potential cause of myocardial ischemia and may affect myocardial function at rest and during stress. We investigated whether CMD was associated with left ventricular diastolic and systolic function at rest and during pharmacologically induced hyperemic stress. METHODS: In a prospective cohort study, we included 963 women with angina, left ventricular ejection fraction (LVEF) >45%, and an invasive coronary angiogram without significant stenosis (<50%)...
December 8, 2017: Echocardiography
https://www.readbyqxmd.com/read/29212500/correction-to-adenosine-stress-cmr-t1-mapping-detects-early-microvascular-dysfunction-in-patients-with-type-2-diabetes-mellitus-without-obstructive-coronary-artery-disease
#13
Eylem Levelt, Stefan K Piechnik, Alexander Liu, Rohan S Wijesurendra, Masliza Mahmod, Rina Ariga, Jane M Francis, Andreas Greiser, Kieran Clarke, Stefan Neubauer, Vanessa M Ferreira, Theodoros D Karamitsos
In the original publication of this article [1] Fig. 1 was incorrect due to the use of a colour bar with wrong range in error.
December 7, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/29209950/spect-myocardial-ischemia-in-the-absence-of-obstructive-cad-contribution-of-the-invasive-assessment-of-microvascular-dysfunction
#14
Loïc Djaïleb, Laurent Riou, Nicolas Piliero, Adrien Carabelli, Estelle Vautrin, Alexis Broisat, Julien Leenhardt, Jacques Machecourt, Daniel Fagret, Gerald Vanzetto, Gilles Barone-Rochette, Catherine Ghezzi
Coronary microvascular dysfunction has recently emerged as a major independent prognostic factor and can be invasively assessed by coronary flow reserve (CFR) and the index of microvascular resistance (IMR). The incremental prognostic value of myocardial ischemia from SPECT myocardial perfusion imaging (MPI) over clinical characteristics, cardiac risk factors, and stress test data for the prediction of hard cardiac events (myocardial infarction and cardiac death) has been well demonstrated over the last two decades regardless of the absence or presence of epicardial CAD...
December 5, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29198139/evaluation-of-the-coronary-flow-by-the-coronary-clearance-time-in-patients-with-cardiac-syndrome-x
#15
Erkan Yildirim, Uygar Cagdas Yuksel, Murat Celik, Baris Bugan, Mutlu Gungor, Yalcin Gokoglan, Mustafa Koklu, Suat Gormel, Salim Yasar, Cem Barcin
Objective The vessels involved in the microcirculation are too small to be visualized by conventional angiography and no tools are currently available that can directly evaluate the coronary microcirculation. This study evaluated the coronary clearance frame count (CCFC) in patients with cardiac syndrome X (CSX). Methods The retrospective study enrolled patients with angina, who had a positive nuclear imaging test and normal coronary angiography; and a control group consisting of patients who underwent an angiogram to exclude coronary artery disease...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29196345/mitoprotection-attenuates-myocardial-vascular-impairment-in-porcine-metabolic-syndrome
#16
Fang Yuan, Ahmad F Hedayat, Christopher M Ferguson, Amir Lerman, Lilach O Lerman, Alfonso Eirin
INTRODUCTION: The metabolic syndrome (MetS) leads to cardiac vascular injury, which may reflect in increased retention of endothelial progenitor cells (EPC). Coronary endothelial cell (EC) mitochondria partly regulate vascular function and structure. We hypothesized that chronic mitoprotection would preserve EC mitochondria and attenuate coronary vascular injury and dysfunction in swine MetS. METHODS: Pigs were studied after 16 weeks of diet-induced MetS, MetS treated for the last 4 weeks with the mitochondria-targeted peptide elamipretide (ELAM, 0...
December 1, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29189827/-coronary-microvascular-dysfunction-past-present-and-future-of-an-evolving-disease
#17
Vincenzo Sucato, Salvatore Evola, Giuseppina Novo, Nicolò Bellante, Giuseppe Andolina, Salvatore Novo
Coronary atherosclerosis is the main cause of myocardial ischemia. Nevertheless 10-30% of patients with angina has angiographically normal coronary arteries. In the last 30 years, several studies showed that in these patients the symptoms can be caused by dysfunction of the coronary microcirculation. Coronary microvascular dysfunction (CMVD) occurring in patients affected by specific cardiac or systemic diseases may be due to mechanisms of the underlying disease. On the other hand, in several patients affected by angina with angiographically normal coronary arteries, there is no specific disease, and CMVD only is responsible for the clinical picture...
December 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29169759/abnormal-coronary-vasoreactivity-in-transient-left-ventricular-apical-ballooning-tako-tsubo-syndrome
#18
Edoardo Verna, Stefano Provasoli, Sergio Ghiringhelli, Fabrizio Morandi, Jorge Salerno-Uriarte
BACKGROUND: The exact etiology and pathophysiologic mechanisms of tako-tsubo syndrome (TTS) remain controversial. OBJECTIVE: To further evaluate the abnormal coronary vasoreactivity and its possible anatomical substrate in TTS. METHODS: We studied 47 patients (46 women; age 67±12years) who underwent diagnostic cardiac catheterization and evaluation of coronary vasoreactivity by sequential acetylcholine (Ach), nitroglycerine and adenosine testing with angiographic and intracoronary pressure-Doppler flow monitoring...
January 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29154426/microvascular-dysfunction-and-cardiac-fibrosis-in-heart-failure-with-preserved-ejection-fraction-a-case-report
#19
Nikhil Narang, Diego Medvedofsky, Kathryn Dryer, Sanjiv J Shah, Charles J Davidson, Amit R Patel, John E A Blair
We report the case of a 55-year-old woman with heart failure with preserved ejection fraction (HFpEF), who presented with hypertensive urgency and pulmonary oedema. The patient was medically optimized and underwent cardiac catheterization revealing pulmonary hypertension, elevated pulmonary capillary wedge pressure, normal cardiac index, and non-obstructive coronary disease. Invasive evaluation of coronary flow revealed blunted coronary flow reserve and increased index of microvascular resistance. Cardiac magnetic resonance imaging demonstrated reduced global myocardial perfusion and diffuse interstitial fibrosis...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29146670/three-vessel-assessment-of-coronary-microvascular-dysfunction-in-patients-with-clinical-suspicion-of-ischemia-prospective-observational-study-with-the-index-of-microcirculatory-resistance
#20
Yuhei Kobayashi, Joo Myung Lee, William F Fearon, Jang Hoon Lee, Takeshi Nishi, Dong-Hyun Choi, Frederik M Zimmermann, Ji-Hyun Jung, Hyun-Jung Lee, Joon-Hyung Doh, Chang-Wook Nam, Eun-Seok Shin, Bon-Kwon Koo
BACKGROUND: Difficulty directly visualizing the coronary microvasculature as opposed to the epicardial coronary artery makes its assessment challenging. The goal of this study is to measure the index of microcirculatory resistance (IMR) in all 3 major coronary vessels to identify the clinical and angiographic predictors of an abnormal IMR. METHODS AND RESULTS: Ninety-three patients who underwent coronary physiological assessment in all 3 major coronary vessels were prospectively enrolled (59...
November 2017: Circulation. Cardiovascular Interventions
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